Personal Disclosure Statement (PDS) for Individual Board Members

Page No. Page 1 of 3 PERSONAL DISCLOSURE STATEMENT Form No. EGLD-447 (PDS) FOR INDIVIDUAL BOARD MEMBERS (Board of Directors of Operators/Applicants) Revision No. 5 Effectivity February 20, 2025 (Year ____________) INSTRUCTIONS 1) Write your answers in block letters. If a question does not apply to you, write “NA”. 2) Place a cross [ X ] in the box if one is provided. Affix 2 x 2” 3) Affix a 2x2 colored photograph taken within the past 6 colored photo here months 4) Send the accomplished and notarized PDS and enclosures in a sealed brown envelope marked “CONFIDENTIAL – PDS” addressed to: Electronic Gaming Licensing Department Philippine Amusement and Gaming Corporation 10th Floor, MET Live Building, Central Business Park 1-A, Macapagal Boulevard cor. EDSA Extension, Pasay City 1300 Part 1 PERSONAL INFORMATION NAME (Last Name) (First Name) (Middle Name) Alias/Other Name Sex  Male  Female Date of Birth (Day of Month) (Month in words) (Year in full) Nationality Tax Identification No. (TIN) CONTACT INFORMATION Address Telephone Mobile E-mail RELATIVES IN PAGCOR, if any Name Name Part 2 ALL AFFILIATIONS WITH PAGCOR LICENSEES Name/s of registered Initials: ________________________________ Date: ___________________(Day / Month / Year)

Page No. Page 2 of 3 PERSONAL DISCLOSURE STATEMENT Form No. EGLD-447 (PDS) FOR INDIVIDUAL BOARD MEMBERS (Board of Directors of Operators/Applicants) Revision No. 5 Effectivity February 20, 2025 company/ies or partnership/s Part 3 INTEGRITY AND FINANCIAL SOUNDNESS The questions below are for any jurisdiction. If you answer “YES” to any question, please provide details in a separate sheet. Indicate offenses and/or circumstances that transpired within and outside the Philippines. 3.1 Have you ever been convicted of an offense?  Yes  No Have you been charged with an offense and awaiting hearing; or otherwise 3.2 subject to a pending prosecution?  Yes  No To your knowledge, are you under investigation by: • The police, customs or any law enforcement agency  Yes  No 3.3 • Any other government agency  Yes  No • Any professional body, trade association or industry regulator  Yes  No Have you ever been censured, disciplined or made subject of an order by 3.4 any professional body, trade association or industry regulator?  Yes  No Have you ever been: • Disqualified from acting as a director of a company 3.5 • Prohibited or prevented from acting in the management or conduct  Yes  No of the affairs of any company, partnership or association • Dismissed, discharged or asked to resign from any employment Have you ever held a Directorship or other senior appointment with any company, partnership or business entity which has been placed during your term into 3.6 • Liquidation  Yes  No • Receivership • Insolvency • Any kind of regulatory administration or monitoring Have you in your personal capacity been declared insolvent by a competent 3.7 regulatory body?  Yes  No Part 4 PROFESSIONAL HISTORY Please use separate sheet as needed. Year Nature of Company Position Title From To Business Part 5 ENCLOSURES Please use separate sheet as needed. 5.1 For Filipino citizens and foreign residents: copy of ITR (duly filed with the BIR) for the previous year 5.2 For non-resident foreigners: copy of valid passport Part 6 DECLARATION AND CONFIDENTIALITY Initials: ________________________________ Date: ___________________(Day / Month / Year)

Page No. Page 3 of 3 PERSONAL DISCLOSURE STATEMENT Form No. EGLD-447 (PDS) FOR INDIVIDUAL BOARD MEMBERS (Board of Directors of Operators/Applicants) Revision No. 5 Effectivity February 20, 2025 I certify that the information provided in this PDS is true, complete and correct of my personal knowledge and/or on the basis of authentic documents in my possession at the time of execution of this PDS. I undertake to provide any further information that PAGCOR may reasonably require about this PDS. I am aware that PAGCOR recognizes my eligibility for membership in the Board of Directors of a PAGCOR-licensed entity on the sole basis of the information provided in this PDS. I understand that the information in this PDS was collected for the sole purpose of demonstrating my eligibility for membership in the Board of Directors of a PAGCOR-licensed entity. As such, the information will be treated with confidentiality and privacy and may not be disclosed to third parties without my prior written consent. For directors of listed licensees: I confirm that I have all the qualifications and none of the disqualifications for a director under relevant laws, circulars and regulations of the Securities and Exchange Commission and the Philippine Stock Exchange, as well as the Articles of Incorporation and By-Laws of ________________________________________________________________________. (State the name of Licensee) IN WITNESS WHEREOF, I hereby affix my signature this ________of ______________ at Manila, Philippines. _____________________________ Affiant SUBSCRIBED AND SWORN to before me this _______ day of ______________________ at _____________ affiant exhibited to me his Community Tax Certificate/Passport No. ________________ issued on ___________ at _______________. Doc. No. ______; Page No. ______; Book No. ______; Series of 20___ Initials: ________________________________ Date: ___________________(Day / Month / Year)